Efficacy and Safety of Polaprezinc-Based Therapy versus the Standard Triple Therapy for Helicobacter pylori Eradication: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 36235778 · doi:10.3390/nu14194126
What was done
A systematic review and meta-analysis (PROSPERO: CRD42022349231) searched Web of Science, Scopus, EMBASE, PubMed, and Google Scholar through July 25, 2022, to identify randomized controlled trials evaluating polaprezinc (zinc-L-carnosine complex) combined with standard triple therapy versus triple therapy alone for Helicobacter pylori eradication. Pooled odds ratios (ORs) with 95% confidence intervals were calculated for intention-to-treat (ITT) eradication, per-protocol (PP) eradication, and overall adverse events.
What was found
Three randomized controlled trials with a total of 396 participants were included (199 receiving polaprezinc plus triple therapy, 197 receiving triple therapy alone). Polaprezinc addition significantly increased eradication rates in both ITT analysis (OR 2.01, 95% CI [1.27, 3.21], p = 0.003) and PP analysis (OR 2.65, 95% CI [1.55, 4.54], p = 0.0004). Total adverse events showed no significant difference between groups (OR 1.06, 95% CI [0.55, 2.06], p = 0.85).
Why it matters
Polaprezinc may act as a non-antibiotic mucosal adjuvant that improves H. pylori clearance rates amidst growing antibiotic resistance, without increasing treatment side effects.
Limits
The total evidence base is very small, consisting of only 3 trials and 396 participants. Specific treatment durations, dosages, baseline resistance profiles, and trial methodological quality are not detailed in the abstract.
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